What is Cerebral Palsy?
Cerebral Palsy (CP) is a neurological disorder caused by non-progressive disturbances in the Central Nervous System (CNS) of developing fetal/infant brain. CP is characterized by a group of disorders affecting the development of movement and posture.
Children with CP can present weak muscles tone around the mouth which causes patients to have difficulties with sucking, chewing and swallowing. They are more prone to having malocclusion (abnormal alignment of the teeth).
How does cerebral palsy affect the oral health of children?
- Children with cerebral palsy tend to have difficulty performing routine activities (such as brushing teeth) due to the difficulty they experience in controlling and moving their limbs.
- Children with CP may present a higher incidence of periodontal disease due to poor oral hygiene.
- Dental caries incidence may be higher among institutionalized patients.
- Increased susceptibility to dental trauma is seen in these children due to the excessive overjet (flaring) of front top teeth and increased tendency to fall, caused by poor muscle coordination.
Dental management and prevention in children with CP
Prevention is essential in managing the dental health of the child with CP. Scheduling the child for early professional dental examinations as well as following a more frequent dental recall schedule is recommended.
Try these Tips
- Brush teeth and gum tissue at least 2 times a day (in the morning and at night before bedtime).
- Use a soft/foam mouth prop to assist the patient in keeping the mouth open.
- Introduce intra-oral stimuli and instruments slowly to minimize patient’s gag reflex.
- Dental visits and topical fluoride application every 6 months.
- Parents should begin brushing when the first baby tooth erupts and should assist their child in brushing.
- Use fluoridated toothpaste; for children under 3 years old use a smear amount of fluoridated toothpaste and for children above 4 years old use a pea size amount.
- Parents should monitor dietary habits (i.e. avoid prolonged use of bottle, reduce amounts of sugar consumed, reduce frequency of sugar consumed).
Preparing the child with CP for a dentist appointment
Discuss the medications currently being taken with the child's dentist. The dental provider will recommend treatment depending on the severity of the child’s condition and treatment necessity. Treatment in the operating room under general anesthesia may be recommended if the patient has potential complications due to other associated medical conditions.
Kimberly Tran, DDS - Nicklaus Children's Pediatric Dentistry Residency Program
Casamassimo,PS, Fields, HW, McTigue, DJ, Nowak. AJ Pediatric Dentistry: Infancy Through Adolescence. St. Louis, Missouri. Elsevier
Casamassimo, PS, Nowak AJ. The Handbook of Pediatric Dentistry 4th edition: Cerebral Palsy. pg 292-293.
National Institute of Dental and Craniofacial Research. Practical Oral Care for People with Cerebral Palsy. https://www.nidcr.nih.gov/OralHealth/Topics/DevelopmentalDisabilities/PracticalOralCarePeopleCerebralPalsy.htm#1. Accessed: 2017-08-28.
Nickel, RE and Desch, LW. The Physician’s Guide to Caring for Children with Disabilities and Chronic Conditions. Paul H. Brookes Publishing Co. 2000